Lunchtime pandemic reading.
Standard disclaimer: this is a roundup of informative pieces I've read that interest me on the severity of the crisis and how to manage it. I am not a qualified medical expert in ANY sense; at best I am reasonably well-read laity. ALWAYS prioritize advice from qualified healthcare experts over some person on Facebook.
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We are now past 30 million jobless claims in the United States. "Jobless claims for the week ended April 25 came in at the lowest level since March 21 but bring the rolling six-week total to 30.3 million as part of the worst employment crisis in U.S. history. Claims hit a record 6.87 million for the week of March 28 and have declined each week since then. Filings continue at a high pace as the government has expanded the list of those eligible for benefits and amid continued difficulties at state offices for claims filers. The Economic Policy Institute earlier this week estimated that the current claims level probably undercounts by as much as 12 million those who are eligible for benefits but not getting them due to the inability to file or other roadblocks."
Source: https://www.cnbc.com/2020/04/30/us-weekly-jobless-claims.html
Almost everyone agrees more needs to be done by governments, particularly the United States. What's challenging is the question of WHAT needs to be done. I maintain that the more you help the bottom of the pyramid - consumers and very small businesses - the more those effects will bubble up to the top. Pouring money into big banks and big corporations doesn't fix people's mortgages and other critical expenses, many of which will have multi-year impacts (ask anyone who lost their shirt in the housing market crash). Advocate to your elected representatives to keep planting seeds at the bottom, rather than trying to water the tops of the existing trees.
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Reich Lab has an incredible forecasting tool for COVID-19 deaths in the United States. You can model the national or state level likely deaths.
Source: https://reichlab.io/covid19-forecast-hub/
No matter which model or algorithm you use, we're going to see many more deaths in the weeks to come. This is a fantastic tool for understanding it.
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Institutional quarantine may be the way to go if people don't comply with home isolation. "European countries and the USA have mostly followed these measures, except, in most cases, only people with severe symptoms are being admitted to hospital, whereas people with mild symptoms are asked to self-isolate at home. Test kit shortages and limited health-care facility capacity have also led to unconfirmed cases self-isolating at home. Compliance with home isolation, however, is partial. In Israel, 57% of people with unconfirmed infection did not self-isolate because they were not financially compensated and because the lay public is not informed on how to keep strict isolation measures at home. Home-based isolation, which is reliant on personal compliance, will therefore inevitably lead to increased transmission. Although cities within Europe and the USA might not be able to create make-shift isolation centres similar to those in Wuhan, due to a lack of social acceptability or negative public perceptions, other strategies should be considered to reduce transmission, such as repurposing hotels or dormitories. We urge policy makers in countries with or facing overburdened health-care facilities to consider such measures as countries emerge from lockdowns."
Source: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)31016-3/fulltext
This is an important message: if people do not voluntarily comply, governments may need to take more drastic measures in order to contain the virus.
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Underpowered studies lead to statistical insignificance. From the Lancet, about the Chinese remdesivir study: "We have already seen how different interpretations will be put on these results, with the unintended early release of this study's results on the WHO website.11 This underlines how labelling of trials is mistaken as positive or negative—equating a p>0·05 with no evidence of benefit. There has been a welcome discussion of p value limitations recently. An absence of statistical significance in an underpowered trial means that the findings are inconclusive. The particular challenges of delivering pandemic trials underline the importance of data sharing, allowing rapid curation of relevant datasets for individual patient data meta-analyses. With each individual study at heightened risk of being incomplete, pooling data across possibly several underpowered but high-quality studies looks like our best way to obtain robust insights into what works, safely, and on whom. We eagerly await the ongoing trials."
Source: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)31023-0/fulltext
Combining underpowered studies is effectively what AI does with marginally significant datasets. The key here is doing so in a meaningful, unbiased way. The other major takeaway here is that the findings of the Chinese remdesivir trial shared yesterday is that we can't rule anything out because it was statistically inconclusive. Neither good nor bad; we'll have to wait for more data from additional trials.
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More evidence of a lack of reinfection from Korea. "South Korea’s infectious disease experts said Thursday that dead virus fragments were the likely cause of over 260 people here testing positive again for the novel coronavirus days and even weeks after marking full recoveries. Oh Myoung-don, who leads the central clinical committee for emerging disease control, said the committee members found little reason to believe that those cases could be COVID-19 reinfections or reactivations, which would have made global efforts to contain the virus much more daunting. “The tests detected the ribonucleic acid of the dead virus,” said Oh, a Seoul National University hospital doctor, at a press conference Thursday held at the National Medical Center. He went on to explain that in PCR tests, or polymerase chain reaction tests, used for COVID-19 diagnosis, genetic materials of the virus amplify during testing, whether it is from a live virus or just from fragments of dead virus cells that can take months to clear from recovered patients."
Source: http://www.koreaherald.com/view.php?ud=20200429000724
Good news for those concerned about whether having COVID-19 grants immunity. At least in this specific case, the relapsed test results are not indicative of reinfection, just genetic material left behind.
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A reminder that keeping kids moving is essential. "Community mobility data from Google across the 15 countries represented by our authorship show that—compared with the week ending Feb 23, 2020, before the WHO pandemic announcement—time spent in places associated with physical activity such as parks, beaches, and community gardens was down by 31%, and travel by public transport, which is also associated with physical activity, was down by 59% during the week ending April 5, 2020, after a pandemic was declared. Conversely, time spent in places of residence increased by an average of 17%. Compared with before the COVID-19 crisis, Canadians aged 15–49 years reported a 66% increase in time watching TV and 35% increase in time spent playing video games between March 29 and April 3, 2020. Interviews done with 15 parents of preschool children in Beijing, China, found that, compared with pre-COVID-19, nearly all children were going to bed later and waking up later."
Source: https://www.thelancet.com/journals/lanchi/article/PIIS2352-4642(20)30131-0/fulltext
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A reminder of the simple daily habits we should all be taking.
1. Wash/sanitize your hands every time you are in or out of your home for any reason. Consider also spraying the bottoms of your shoes with a general disinfectant (alcohol/bleach/peroxide) when you return home.
2. Wear gloves and a mask when out of your home.
3. Stay home as much as possible.
4. Get your personal finances in order now. Cut all unnecessary costs.
5. Donate any PPE you can. https://getusppe.org/give/
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Common misinformation debunked!
There is no genomic evidence at all that COVID-19 arrived before 2020 in the United States and therefore no hidden herd immunity:
Source:
There is no evidence SARS-CoV-2 was engineered.
Source: https://www.washingtonpost.com/world/2020/01/29/experts-debunk-fringe-theory-linking-chinas-coronavirus-weapons-research/
Source: https://www.nature.com/articles/s41591-020-0820-9